Telehealth or In Person: Which Visit Do You Actually Need
Video is genuinely good for some things and quietly useless for others. Here is the dividing line.
Telehealth was oversold for a stretch and then quietly undersold once offices reopened. The truth is narrower than either: it is genuinely good for a specific set of problems and close to useless for another set.
Works well by video
Follow up on a stable chronic condition. Reviewing home blood pressure readings, checking in on a medication change, going over labs that are already drawn. If the data is coming from home anyway, driving here adds nothing.
Lab and imaging results. A real conversation about what a result means, rather than a portal message with numbers and no interpretation.
Medication questions and most refills, where no examination or new monitoring is required.
Mental health follow up. Anxiety and depression follow up works well by video, and for some people it works better, because the barrier of getting to an office is itself part of what is hard.
Rashes, sometimes. With good lighting and a clear photo sent ahead, a fair number of skin complaints can be handled. Not all of them.
Triage. Deciding together whether something needs to be seen today, this week, or not at all. This is underrated, because it often saves the trip rather than replacing it.
Needs an in person visit
Anything requiring a stethoscope. Chest pain, shortness of breath, a cough that has changed character, palpitations. Video cannot listen to your lungs.
Abdominal pain. Where it hurts when pressed, and how it responds, is most of the diagnosis. There is no remote version of that.
Ear pain, and most sore throats. An ear needs an otoscope, and a throat that warrants a strep test warrants a swab.
Injuries. Anything where the joint needs to be moved, stressed and compared with the other side.
Annual physicals and Medicare Annual Wellness Visits. Beyond the exam, these usually involve vitals and labs.
Anything needing a procedure, including joint injections, wound care or ear wax removal.
A first visit, usually. Establishing care goes better in person. Baseline vitals, a proper exam and a face to face conversation make everything afterward more useful, including later video visits.
Do not use either. Call 911
Some things are not an appointment of any kind:
- Chest pain or pressure, particularly with sweating, nausea, or pain into the arm or jaw
- Sudden weakness or numbness on one side, facial droop, trouble speaking or sudden severe headache
- Difficulty breathing at rest
- Fainting, or confusion of sudden onset
- Severe bleeding, or a severe allergic reaction
Booking a video visit for a stroke costs the exact minutes that matter most.
What actually makes a video visit useful
Have your numbers ready. Home blood pressure readings, glucose logs, weight. Be somewhere with decent light and a stable connection where you can talk freely, which usually means not a parked car between meetings. Have your medication bottles within reach. Send photos ahead of time rather than holding a phone camera up to a laptop camera.
And be direct about what you actually want out of the visit in the first minute. Video calls tend to end faster than office visits, and the thing you were going to mention at the end sometimes does not get mentioned at all.
How we use it
We offer telehealth for the situations above, for patients age 16 and older. We will tell you honestly when video is not the right format, including when you have already booked one, because a virtual visit that cannot answer your question is worse than no visit at all.
Book a visit and note which format you would prefer.
Common questions
Is a telehealth visit covered by insurance?
Usually, though coverage and cost sharing vary by plan and have changed several times in recent years. Ask when you book and we will tell you what we know, though only your insurer can confirm your benefits.
Can you prescribe during a telehealth visit?
For many conditions, yes. There are meaningful restrictions on certain controlled substances, and some medications require monitoring such as labs or a blood pressure check before a refill is appropriate.
What if we start on video and it turns out I need to be seen?
Then we bring you in. That happens sometimes and it is a normal outcome rather than a wasted visit, because the video call still sorted out how quickly you need to be here and what to prepare.
This article is general health information for adults age 16 and older, not medical advice for your situation, and reading it does not create a patient relationship. For advice about your own health, book a visit. If you think you are having an emergency, call 911.